Syncope (peds)

For adult patients see syncope


  • Usually because of an abrupt cerebral hypoperfusion (30-50% from baseline)
  • Peak age: 15-19 years of age
  • In younger children, usually due to seizures, breath-holding spell or cardiac disease

Red flags

  • Exercise-induced collapse
  • Chest pain
  • Previous cardiac surgery
  • Family history of:
    • Sudden Death
    • Cardiac disease at early age
    • Unexplained deaths
    • Death due to single-vehicle accident
    • Drowning
    • SIDS

Clinical Features

  • Abrupt loss of consciousness with full recovery after a short duration

Differential Diagnosis

Syncope (peds)



  • ECG
  • Urine pregnancy (if age/sex appropriate)

Consider based on history/symptoms



  • Directed towards reversing the cause


  • Admission if any ECG abnormality found
  • Admission usually not warranted – consider admitting kids with eating disorder
  • Consider discharge home with cardiology consult and strict activity restrictions if suspicion of hypertrophic cardiomyopathy in otherwise well patient with reliable caretakers

See Also


  • Fischer and Cho. Pediatric Syncope: cases from the ED. Emerg Med clin N Am. Vol 28. 2010. Pp 501-516.